Uterine cancer, often referred to as endometrial cancer, is the most common gynecological cancer in the United States. It forms in the uterus, which is the hollow, pear-shaped organ in the lower abdomen where a fetus develops and grows. Endometrial cancer most commonly occurs after menopause.
This type of cancer is curable, particularly when it is diagnosed and treated early. Hysterectomy is considered the primary treatment option, but there are other medical treatments used to manage the condition.
There are two main types of uterine cancer. They grow in different types of tissue, and there are many subtypes within those categories.
Endometrial Cancer This type of uterine cancer develops in the lining of the uterus, which is also known as the endometrium. Approximately 95 percent of uterine cancers are endometrial, which is why the terms “endometrial cancer” and “uterine cancer” are often used interchangeably.
Uterine Sarcoma This type of uterine cancer originates in the muscle wall of the uterus. It is relatively rare.
Endometrial cancer can cause symptoms in both the early and more advanced stages. Roughly 90 percent of patients diagnosed with endometrial cancer report postmenopausal vaginal bleeding, bleeding between periods, or very heavy bleeding during their menstrual cycle.
Endometrial cancer can be detected with several types of examinations.
Pelvic Exam During a pelvic exam, your doctor will insert two fingers into the vagina while pressing the other hand down on the abdomen to feel for abnormalities in the uterus and the ovaries. A speculum is inserted into the vagina to visually inspect the area.
TransvaginalUltrasound In this exam, a wandlike device known as a transducer is inserted into the vagina to create an ultrasound video image of the thickness of the uterine lining and determine if there are irregularities.
Hysteroscopy During this test, a lighted tube, or hysteroscope, is inserted into the vagina and through the cervix to gain access to and examine the uterus and uterine lining.
EndometrialBiopsy Thin suction tubing is used to remove tissue from the uterine lining to be examined and analyzed by a laboratory.
Dilation and Curettage If an endometrial biopsy is inconclusive, it may be necessary to do a more extensive procedure called dilation and curettage, or D&C. The cervix is dilated for better access to the uterus and the endometrial lining is scraped to get additional tissue for testing.
Stages of Uterine Cancer
If abnormal cells are detected, the cancer will be classified by one of four stages. All cancers are more curable the earlier they are discovered.
Stage 1 The cancer has not spread beyond the uterus.
Stage 2 The cancer has spread from the uterus to the cervix.
Stage 3 The cancer has spread from the uterus to the vagina, ovaries, and lymph nodes.
Stage 4 The cancer has spread to the bladder, rectum, lungs, or bones.
Endometrial cancer is treated by one or a combination of treatments. Ultimately, treatment for uterine cancer depends on the type of cancer and how extensive it is, as well as whether it is localized or has spread (metastasized). Other factors include overall health, age, and personal preferences, such as whether it is important to preserve fertility.
Surgery
A total hysterectomy is the main surgical treatment for uterine cancer. That procedure removes the entire uterus and the cervix. A bilateral salpingo-oophorectomy (removal of the ovaries and fallopian tubes) may also be performed to reduce the risk that the cancer will spread. Your doctor may also remove lymph nodes from the pelvic area to test for any cancer that may have spread outside of the uterus.
Hormone Therapy
Hormone therapy blocks or changes the effects of hormones that contribute to cancer growth. It’s sometimes used in patients who want to preserve the uterus and their fertility. It’s also often used to treat stage 3 or 4 cancer or cancer that has recurred after treatment.
Medication is prescribed to lower the body’s hormone levels so that uterine cancer cells, which grow in response to hormones, might die off. Depending on the drug prescribed, it comes in pill or injection form. Hormone treatment options for endometrial cancer can include:
Progestins, which are the primary hormone treatment prescribed
Aromatase inhibitors (AIs)
Tamoxifen
Fulvestrant
CDK 4/6 inhibitors
Chemotherapy
Chemotherapy is a type of cancer treatment that uses powerful medicine to kill cancer cells. It’s an effective way to treat cancer, but it also can cause unpleasant side effects such as nausea, fatigue, hair loss, nerve damage, and a loss of appetite. It can be used alone or in combination with other treatments, like surgery and radiation, to improve the patient’s chance for survival.
Drugs that are used to treat uterine cancer include:
bevacizumab (Avastin)
carboplatin
cisplatin
docetaxel (Taxotere)
doxorubicin (Adriamycin) or liposomal doxorubicin (Doxil)
gemcitabine
paclitaxel (Taxol)
Radiation Therapy
Radiation therapy is often used after surgery to destroy any remaining cancer cells. This is the main treatment for women whose cancer has returned, and for those who have health conditions that won’t allow them to have surgery. It’s often done along with chemotherapy to eliminate large uterine tumors or cancer that’s spread to other parts of the body.
Your doctor may order computerized tomography (CT) scans during treatment to ensure that the radiation avoids nearby healthy organs and tissues and to track the shape and size of the tumor. Radiation therapy can be given two ways:
Internal radiation therapy, which is when radioactive materials are placed inside the body. It’s also known as brachytherapy.
External beam radiation therapy, which is performed with a machine that focuses radiation beams at the tumor.
Targeted Therapy
Targeted drug treatments are designed to attack changes within cancer cells. They are mostly used to treat high-risk endometrial cancers and those that have metastasized. They have different and possibly less severe side effects than chemo drugs, but they are sometimes combined with chemotherapy.
Targeted drugs include:
bevacizumab (Avastin), Trastuzamab (Herceptin)
cabozantinib (Cabometx)
entrectinib (Rozlytrek)
everolimus (Afinitor)
fam-trastuzumab deruxtecan-nxki (Enhertu)
larotrectinib (Vitrakyi)
lenvatinib (Lenvima)
temsirolimus (Torisel)
Immunotherapy
Immunotherapy uses drugs that help the patient’s own immune system fight the cancer. In the case of uterine cancer, a type of immunotherapy known as a checkpoint inhibitor, specifically a drug called pembrolizumab (Keytruda), may be used. Pembrolizumab is sometimes used in tandem with the targeted therapy lenvatinib (Lenvima). Dostarlimab is another immune checkpoint inhibitor that may be used alongside chemotherapy to treat advanced or recurrent endometrial cancer.
While there is no foolproof way to prevent uterine cancer, certain behaviors can lower your risk factors.
Maintain a healthy weight. Women who are overweight are more likely to get endometrial cancer.
Exercise regularly. Higher levels of physical activity have been linked to a lower risk of endometrial cancer. Regular exercise can also help you maintain a healthy weight and lower the risk of high blood pressure and diabetes, both of which are risk factors for endometrial cancer.
Use hormonal contraceptives. Birth control pills, patches, rings, implants, or an IUD may reduce your endometrial cancer risk.
When you’re being treated for cancer, living a healthy lifestyle may help improve your day-to-day life and your prognosis. A healthy diet, regular exercise, avoidance of cigarettes and alcohol, and more sleep can help you improve your health and possibly minimize some cancer treatment side effects, such as fatigue, nausea, stress, anxiety, and depression.
Every patient with uterine cancer is different, and so are their health outcomes. When diagnosed early, patients with uterine cancer have a very good prognosis.
Those diagnosed before the cancer metastasizes have a five-year survival rate of 95 percent. If the cancer has spread to other areas of the body, the survival rate is 18 percent.
Cancer of any type is serious, and there can be some significant complications related to both the disease and the treatment, including:
Anemia due to blood loss before diagnosis
Perforation (hole) of the uterus, which may occur during a dilation and curettage (D&C) or endometrial biopsy
Nausea or vomiting from chemotherapy
Increased risk of infection from surgery, radiation, and chemotherapy
Uterine cancer is the fourth most common cancer for women and the most common gynecological cancer in the United States. In 2025, an estimated 69,120 women will be diagnosed with this type of cancer, and an estimated 13,860 people will die of uterine cancer this year.
Although uterine cancer rates are slightly higher among white women than Black women, Black women are almost twice as likely to die of it. One study found that racial disparities are reflected in higher rates and shorter survival among Black women.
One reason for the shorter survival time is late diagnosis. Because Black women are less likely to be diagnosed in the early stage of the disease, their survival rate is lower at every stage. Additionally, Black women tend to have cancers with specific molecular factors that make them more difficult to treat. Some of these molecular subtypes might respond better to newer types of treatments, such as immunotherapy.
Uterine cancer, also called endometrial cancer, is the most common gynecological cancer in the United States. It is diagnosed most frequently in postmenopausal women.
Early diagnosis and treatment of uterine cancer can lead to a very good prognosis. Surgery is the main treatment option, but others include hormone therapy, chemotherapy, radiation, targeted drugs, and immunotherapy.
If you experience postmenopausal bleeding, difficulty urinating, or pelvic pain, seek medical attention right away, as these can be symptoms of uterine cancer.
